Clinics and Departments

Laboratory Services

Lab Dept:

Serology

Test Name:

HYPERSENSITIVITY PNEUMONITIS SEROLOGY

General Information

Lab Order Codes:

HPS

Synonyms:

Hypersensitivity Pneumonitis Serology, Serum; Allergic Lung Serology; Aspergillus Fumigatus; Farmer’s Lung Serology; Farmer’s Lung Antibody; Micropolyspora Faeni; Precipitin Aspergillus Fumigatus; Precipitin Micropolyspora Faeni; Precipitin Thermoactinomyces Vulgaris; Thermoactinomyces Vulgaris; Apergillus Preciptans

CPT Codes:

86606 – Antibody; aspergillus
86671 x2 – Antibody; fungus, not elsewhere specified

Test Includes:

IgG antibodies to Micropolyspora faeni, Thermoactinomyces vulgaris, and Aspergillus fumigatus

Logistics

Test Indications:

Evaluation of patients suspected of having HP induced by exposure to Aspergillus fumigatis, Thermoactinomyces vulgaris or Micropolyspora faeni

Lab Testing Sections:

Serology - Sendouts

Referred to:

Mayo Medical Laboratories (MML Test: SAL)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

1 – 3 days, test set up Monday - Friday

Special Instructions:

N/A

Specimen

Specimen Type:

Blood

Container:

Red top tube

Draw Volume:

1.5 mL (Minimum: 0.9 mL) blood

Processed Volume:

0.5 mL (Minimum: 0.3 mL) serum

Collection:

Routine venipuncture

Special Processing:

Lab Staff: Centrifuge specimen, remove serum aliquot into a screw-capped round bottom plastic vial. Ship and store serum at refrigerated temperatures. Forward promptly.

Patient Preparation:

None

Sample Rejection:

Specimens other than serum, mislabeled or unlabeled specimens

Interpretive

Reference Range:

Organism IgG Ab

Age:

Reference range (mg/L):

Aspergillus fumigatus

<4 years:

Not established

≥4 years:

≤102

Micropolyspora faeni

0 - 12 years:

≤4.9

13 - 18 years:

≤9.1

>18 years:

≤13.2

Thermoactinomyces vulgaris

0 - 12 years:

≤6.6

13 - 18 years:

≤11.0

>18 years:

≤23.9

Elevated concentrations of IgG antibodies to Aspergillus fumigatis, Thermoactinomyces vulgaris, or Micropolyspora faeni in patients with signs and symptoms of Hypersensitivity Pneumonitis is consistent with disease caused by exposure to 1 or more of these organic antigens. Extreme elevations (>5 times the upper limit of normal) occur in some patients with active disease.

Critical Values:

N/A

Limitations:

IgG antibodies to Aspergillus fumigatus, Thermoactinomyces vulgaris or Micropolyspora faeni are detectable in sera from healthy individuals and the presence of antibodies is not sufficient to establish the diagnosis of Hypersensitivity Pneumonitis.

Elevated concentration of antibodies to Aspergillus faeni are found in patient with invasive aspergillosis and cavitary lung disease as well as Hypersensitivity Pneumonitis.

The levels of antibodies to these antigens often decrease following treatment; but elevated levels may persist in treated patients for long periods. The measurement of IgG antibodies to these antigens should not be relied upon exclusively to establish the diagnosis of Hypersensitivity Pneumonitis.

Methodology:

Fluorescence Enzyme Immunoassay (FEIA)

References:

Mayo Medical Laboratories July 2013

Updates:

7/12/2006: Reference ranges expanded to include pediatrics and method previously listed as Immunodiffusion.
4/28/10: Updated minimum volumes
8/23/12: Reference range change for Aspergillus fumigatus, IgG



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